A stride in the right direction

Here’s hoping the 4th July 2011 will go down in history.  The day that Andrew Dilnot made successful recommendations for long term care reform, that the Government accepted, took forward in legislation and were implemented with pace.

We have a long way to go before we can claim success, but Dilnot’s proposals for reform are a good start towards this goal.

Andrew Dilnot was given the unenviable task of proposing recommendations which would create a better care system, one which was more sustainable, fair, easier to understand and affordable.  He has worked meticulously, gathering evidence, statistics, views from the general public and from stakeholders such as Age UK.  In subsequent blogs I will look at each of the tests in more detail, but here are some initial reactions to his proposals:

1. We welcome that Dilnot has called for more national funding – between £1.3bn and £2.2bn.  Without investment in social care any reform will not be sustainable and is liable to run into future difficulties.  We have repeated throughout this process that the Government cannot afford not to reform care, and that by investing in better essential services the Government will save more in health, housing and welfare interventions.  We know there will be a big debate about where this money comes from, but these issues can be answered.

2. We also welcome the increased certainty this package of proposals sets out.  Whilst £35k is not insubstantial, the reality is that many people pay more than this currently for their care, and those that don’t are fearful they might have to.  What the cap does is take the guessing game out of care and encourages people to plan ahead and to think about their future.  It’s one of the big disincentives in the current system and the cap will remove this.

3. One of the biggest surprises of today’s report is the increase to the means test threshold from £23,250 to £100,000.  This is good news for many people, easing the concern about leaving assets as inheritance and the frustration of using assets for care fees.  In reality this threshold will only affect those people who need residential care, as it is a small proportion of older people who have more than £100k in savings and non-housing assets.

4. Amongst the top social care bugbears is the current variation in provision between the individual local councils.  Dilnot’s recommendation for a consistent threshold is therefore very welcome.  It raises issues of local finance allocation, service provision and prices, but these are for another day.  What matters is that older people will be able to take an assessment and move house in confidence that their needs will continue to be met.

5. Dilnot has accepted one of the fundamental arguments on disability benefits: that they are preventative, and that in a system which, at least in the short term, will only provide for higher needs, are an important way of broadening the reach of the state to people with lower levels of need.  We also agree, however, that there is a branding exercise to do on Attendance Allowance, starting with a change of name to make its purpose clearer.  But this is cosmetic, and we’re pleased that disability benefits will remain.

It’s also important to remember that funding is only one piece of the puzzle.  We have a challenge ahead to improve the quality of care so that it is consistent and reliable.  We also need to foster transformational change so that care services are prioritised, recognised as essential and given their due.  Without tackling poor quality and creating better ways of providing services we will not be successful in achieving our goal of better care.

So what next?  Other than continuing to read and digest the detail, share concerns and celebrate the good bits?  Our attention turns to the Government, who in commissioning this report laid itself open to calls of subsequent action.  We have all heard the political rumours last week that particular parts of the Cabinet are concerned about the proposals.  However, we must press on in good faith that the groundswell of opinion on care reform will be so great that it cannot be ignored, and that the Government feels compelled to act.  Age UK and other stakeholders have a role to play in helping shape the ensuing debate and supporting older people to campaign and lobby their MPs.

Watch this space for more detailed thoughts on the proposals.

6 responses to “A stride in the right direction

  1. Keith Ferguson

    You say :”However, we must press on in good faith that the groundswell of opinion on care reform will be so great that it cannot be ignored, and that the Government feels compelled to act. ” How is this groundswell to be communicated? Age UK could take a lead here – a petition, perhaps, or a campaign directing those who have strong views to register them? As an individual in my 60s with no immediately foreseeable care needs, I am nonetheless delighted with the content of the Dilnot report, because it caps both asset and income required for care at levels that seem fair, and so leaves me with the feeling that all my financial probity over the years will not disappear rapidly should need for care emerge. Age UK, please help me and others who feel the same to communicate our message. We may be getting on, but we still have the vote!

  2. Really useful analysis, Lizzie – thanks for sharing. Look forward to your further posts.

  3. Pauline Turner

    Make sure you keep writing to your MP and don’t let up. Make sure that when you get an opportunity to email anyone on the subject of Care for the Elderly take the time to do so. I did write to Mr Dilnot when the discussions were taking place and his office was kind enough to write back and said he would use my information for Call for Evidence. The majority of people that vote are the older generation so make sure your MP knows that because they could find themselves out of a job. Power to the people our votes are important.

  4. You say that evidence from other countries where free personal care is available shows that the funding pressures become so great that care becomes restricted and availability declines. We would disagree. See: http://bit.ly/n47wl0

  5. Mr R W Peters

    This is a most unfair system. People who do not save for their care will not have to pay anything for any care they may need.
    National Health Service contributions should be increased to provide free care for all.The contributions should be based on income. erners

  6. Just returned from my summer holiday and have been catching up with everybody’s comments on the Dilnot report. Well done Lizzie, your review of the issues raised in the report is one of the best I’ve seen to date.

    Overall, I believe the most important thing is that Dilnot has created a platform for the insurance industry to come up with some new long-term care insurance products. I have commented myself on the issues in my Grumblesmiles blog. We all now have to wait and see how the politicians will carve up his recommendations. I can’t believe they will avoid doing some damage to his proposals.

    As you say the other big outstanding issue is what will be done about the appaling quality of most residential care provision

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